Birth and Back Pain-The Birth Story of Joseph Finn Metcalfby Kathy As the weeks went by and the weather got warmer, then hot, then humid, I started to really feel sorry for those women who will or have been pregnant during the summer months in the DC area. The week before Finn made his arrival was HOT...100 degree days with high humidity left me swollen and confined to the house praising the air conditioner gods and laying on the chaise with my feet up the wall. Granted, this is how I've spent most of my pregnancy due to back surgery and then later, excessive swelling in my feet. The night of Friday, June 10th Dan took us out to dinner where I started having menstrual type cramps. Exactly the type right before my period that had me thinking "Midol...when is my period due, again?". I've been of the mentality that my pregnancy would go long and had made up my mind that the baby would arrive no earlier than June 20th. Especially as my older sister had her baby five days after her due date and the 20th would be five days after mine. Anyway, that evening the menstrual type cramps kept coming off and on, warm ups to the big event. There was no pattern and eventually I stopped noticing them and went to sleep with Dan watching The Empire Strikes Back. I woke around 2:30 am on Saturday morning to more intense cramping that didn't allow me to sleep through each squeeze anymore. Again, there was not much of a pattern and if I had timed them, I would guess they would be 20-30 minutes apart (probably closer)...who knows, I refused to time them. They continued like that through the day and with each squeeze I would have to stop what I was doing to breath and relax into it. Dan took me to breakfast and HE started to time them since I wasn't doing a good job of it. They were every 15 minutes but I still couldn't see the pattern. As a doula, I always tell my clients to deny deny deny until you can't deny its labor any longer. As the day wore on I rested and napped (as usual), had girlfriends over and continued to have the squeezes every 20-30 minutes. They weren't picking up but I definitely had to concentrate through each one. One of my girlfriends who was down visiting, Susan, was also to be my doula so she watched through each one and probably realized that it was SUPER early labor. She went home that night and I asked her to keep her phone with her in case I needed her. She, in turn, asked me to update my midwives just in case. Talking with Mairi, my midwife, she suggested Dan and I have a good meal, have a glass of wine or some tea and get some sleep because although this could be it, these squeezes have also been known to go on for days or even weeks. With that advice, Dan and I celebrated the 7th anniversary of our first date by going out to a nice dinner, I had a glass of wine and later a mug of tea and fell asleep again that night watching the second half of Empire Strikes Back (Dan tells me this is a necessity for the education of all children-the originals, not the new ones). Again, I awoke around 2am not able to sleep through the squeezes anymore and actually starting to have to moan through each one. I stayed in bed as long as possible but by 4:30am it was time to start moving. Dan was up with me and he called the midwife to give a status update; again, we were told to drink some camomile tea (helps reduce uterine irritability in case this was just false labor, it might help stop the squeezes) and call back if anything changed. For the next couple hours I was mostly on my hands and knees laying my chest across the chaise in our living room concentrating through each squeeze and resting in between. By 7:30, we had called our birth team motivating each member to start on their way towards us and Dan was working on filling up the birth-pool out back. I don't remember much of the day as it's all a big blur of back pain and movement, but I know I was in and out of the birth-pool, up and down the stairs, sitting on the toilet both upstairs and down and then back to the birth-pool. After a brief stint of my hubby diligently timing my squeezes on the computer via "contractionmaster.com" we realized timing was irrelevant; clearly, I was in labor. I would have a squeeze in the front like a hard menstrual cramp that immediately radiated to a squeeze and then an intense burn through my lower back. With eyes closed, moaning helped me to keep my center but nothing seemed to help the back pain. The pool was a wonderful relief from gravity and luckily the weather cooperated with our birth and remained cool while I labored for the hours on the back deck. Eventually, I made my way upstairs one last time. Things had been moving along all day and though I seemed to be making the same types of sounds, things had changed and there was more intensity to each squeeze. Dan was my rock, constantly there giving his quiet support, keeping me hydrated and offering encouraging words. Susan, also a constant presence, kept my spirits up with words of encouragement and reminders that this was all for a very special reason and that each one was getting me closer to my baby. The last hour or two of labor took on even more intensity and at times I feel like I kept second guessing myself. Having attended so many births as a doula, I know which sounds mean baby is getting closer...so, I felt myself making those sounds because that's where I wanted to be, not necessarily where my body was telling me I was. Knowing my background and being a very intuitive midwife, Mairi asked if I'd like to be checked to see how far along I was and I was more than happy to agree. After the next contraction, I rolled on my back and found out that all my hard work was not in vain as I was 8-9 cm dilated (10 cm is fully open and where I can start to push baby out)...great, that's good but still not done. And I was ready to be done. Mairi, again, seeing my impatience recommended squatting through a few squeezes to help push baby's head down on my cervix harder and open me up those last few centimeters. It was mentally one of the hardest things to do...at that point I really had to dig in and make a choice. Do I do the hard thing and move things along quicker (which was the ultimate goal) or do I keep doing what I'm doing and things will move along in their own time? I preferred to speed things along so I tried to squat...after a few seconds into the contraction I lost it and that contraction was harder to get through because I'd lost my center. I tried again with the next one and had the same reaction. With Mairi's help and Dan's support, I tried again, and pushed myself to stay down, yelling to baby to "GO DOWN BABY, GO DOWN." I worked hard through the next 5-10 squeezes (I have no concept of time at this point) and wound up sitting on the toilet for a rest. I remember at that point looking at the clock and seeing it was almost the time that my older sister, Julie, gave birth to her own first child, Esme, a week prior and I got very emotional thinking that, oh my gosh, I'm having a baby! And how special it is that Julie and I are connected like we are, having babies at essentially the same time. Mairi came in and said that this "emotion soup" was a good sign and to just flow with it. She also suggested a quick shower and to brush my teeth as a way to freshen up and give myself more energy before having to push. I took her up on her suggestiong and leaned on Dan in the shower through more squeezes and again found myself back on the toilet. At that point, Dan ran downstairs for an icepack for my back leaving Susan and I in the bathroom. As I sat on the toilet I was trying to push baby down with each squeeze and all of a sudden I grunted and my waters broke with a quick gush. Susan immediately jumped in, grabbed me and told me that things would get much more intense and that it was okay (and boy was I glad she was there!). She helped me hold my center by talking me through the next squeezes which were much more intense before we made the final move to the bedroom. On the bed I tried pushing on hands and knees and it just didn't feel right (plus, I felt the baby get hiccups at this point-quite an interesting sensation to feel baby hiccups in your bottom!). I flipped on my back for the next one and found the bed too squishy (what is this?! Goldilocks? This one's too soft, this ones too hard...) so we moved all the pads to the floor at the foot of the bed with plenty of pillows against the base to support my back as I reclined against the bed (ah, just right). Dan had gotten me an ice pack that helped numb up my back as I continued to have the burning in my sacral area with each squeeze. I reached down during a couple squeezes and felt babies head and which pushes were effective and then really got down to pushing this kiddo out. I pushed for 30-45 minutes with Susan at my head whispering encouraging words the whole time and Dan as my stirrup as he watched his newborn emerge. I remember thinking, how do people do this!? Get the vacuum, get the forceps, pull this kid out, there's now WAY I'm pushing baby out on my own! I didn't feel much in my perineal area because of all the burning I felt in my back and again, I had to make the bargain to do the hard thing; push through the intensity and get the kid out or push lightly and prolong the sensations. I pushed with all my might and felt the baby move down, crown and finally out. We had our baby! Dan caught Kiddo with the help of the midwife and got the baby onto my belly immediately for some skin to skin tummy time (would have been chest to chest but the umbilical cord was a bit short and baby couldn't reach). What euphoria it was to finally be done! Dan and I just reveled in the knowledge that we were now parents, can you believe it?!

After a few minutes of crying and kissing and enjoying the moment I realized we still didn't know what the sex was...What is it?! Dan took a quick peek...IT'S A BOY! More crying tears of joy and Dan named him Joseph Finn Metcalf, who will go by Finn. Welcome little man, we are SO GLAD you're here.

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